Which Commonly Prescribed Drug is More Effective for Infants with Epilepsy?

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Levetiracetam found to be superior to phenobarbital as initial monotherapy for infants with nonsyndromic epilepsy

Comparison of two of the most commonly prescribed drugs for infants with nonsyndromic epilepsy revealed that levetiracetam was more effective than phenobarbital, according a multicenter, observational study. After six months of single-drug treatment, 40 percent of infants who received levetiracetam met criteria for successful outcome – they did not require a second anti-epileptic drug to control their seizures and they became seizure-free within three months of starting treatment. Only 16 percent of infants treated with phenobarbital achieved the same outcome.

“This is the first study to provide evidence that may help clinicians select an initial treatment for infants whose epilepsy does not conform to a known syndrome, which accounts for more than half of infants with epilepsy,” said senior author Anne T. Berg, PhD, from Stanley Manne Children’s Research Institute at Ann & Robert H. Lurie Children’s Hospital of Chicago. “Our findings suggest that a change in practice could meaningfully improve outcomes for these babies. Since there are no randomized controlled trials to guide treatment for nonsyndromic epilepsy in this age group, we are excited that evidence-based care is now possible for this population.”